Journal of the American Academy of Audiology最新文献

Background:  The Dichotic Digits Test (DDT) evaluates central auditory nervous system (CANS) dysfunction. The DDT is widely used in audiology clinics worldwide, because it is clinically efficient and has good sensitivity and specificity for CANS lesions. However, the DDT shows a strong ceiling effect, which can mitigate its ability to detect subtle CANS dysfunction.

Purpose:  This study examines the effects of adding monaural and binaural speech-spectrum noise to the DDT in an effort to make the test more taxing to the CANS and thereby reduce the observed ceiling effect.

Research design:  This was an experimental repeated measures study.

Study sample:  The participants were 20 adults aged 18 to 50 years with bilaterally symmetric speech-reception thresholds and pure-tone thresholds (250-8000 Hz) of 25 dB HL or better.

Data collection and analysis:  Each participant was administered one standard DDT test list (no noise added) and DDT test lists with binaural, monaural right, and monaural left noise added. For each of the noise-added conditions, lists were administered at two different signal-to-noise ratios, for a grand total of seven DDT test lists per participant, presented in randomized order. Monaural and binaural noise effects on DDT scoring indices (Right and Left Ear Percent Correct Scores, Combined Total Percent Correct Scores, and Dichotic Difference Scores), as well as noise effects on the right ear advantage for speech, were examined. Mixed model analyses of variance were used to examine fixed effects and interactions of Noise Condition and Ear.

Results:  Adding noise to the standard DDT systematically reduced Right and Left Ear Percent Correct Scores and Combined Total Percent Correct Scores. Statistically significant differences on all indices were found between monaural and binaural noise-added conditions, suggesting a possible advantage for binaural listening in noise.

Conclusions:  These findings suggest that adding noise to tests of dichotic listening increases the difficulty of the task, and that further investigation of dichotic listening patterns in noise could potentially lead to more sensitive clinical evaluations of CANS integrity and function.

Background:  The Claus Elberling Chirp (CE-Chirp) stimulus used in the auditory brainstem responses (ABRs) was developed to compensate for the cochlear wave delay. As a version of broadband CE-Chirp stimulus, the use of level-specific (LS) CE-Chirp stimuli, which are created with varying delay models suitable for the intensity levels at which the sound is transmitted, is becoming increasingly common.

Purpose:  The aim of this study was to compare click ABRs with LS CE-Chirp ABR thresholds in adults with sensorineural hearing loss.

Research design:  The research is a cross-sectional, analytical research.

Study sample:  Twenty-two adult patients (n = 44 ears) with bilateral sensorineural hearing loss were included in the study.

Data collection and analysis:  Pure-tone audiometry, click ABR, and LS CE-Chirp ABR tests were performed on adult (13 males and 9 females; 42.86 ± 14.50 years) patients with bilateral sensorineural hearing loss. Click ABR and LS CE-Chirp ABR thresholds were compared in terms of proximity to behavioral hearing thresholds of 2 kHz, 4 kHz, and 2 to 4 kHz averages.

Results:  Both types of ABR stimuli were able to identify with total hearing loss (n = 6). A significant difference was found between LS CE-Chirp ABR thresholds (53.81 ± 20.28 decibel normal hearing level [dB nHL]) and click ABR thresholds (58.81 ± 19.11 dB nHL) in the other ears (n = 38) with hearing loss (p = 0.00). When both ears were evaluated together and the right and left ears were evaluated separately, no difference was found between LS CE-Chirp ABR thresholds and 4 kHz hearing thresholds (p = 0.66, 0.80, and 0.69, respectively).

Conclusion:  In adults with hearing loss, the LS CE-Chirp provides ABR thresholds closer to the behavioral hearing thresholds at 2 and 4 kHz compared with the click stimulus. Notably, there was no difference between LS CE-Chirp ABR thresholds and the 4 kHz behavioral hearing thresholds. We concluded that the LS CE-Chirp can be used effectively in the estimation of behavioral hearing thresholds in adults with hearing loss.

Background:  Congenital hypothyroidism (CH) is one of the most preventable causes of intellectual disability in the world. Screening programs have led to earlier detection of CH, and children with adequate thyroid supplementation can have minor long-term differences in overall neuropsychological testing compared to baseline.

Purpose:  Despite early identification, up to one-fourth of children born with CH suffer from hearing loss even with early and adequate thyroid hormone supplementation. We present a unique case of an individual born with congenital hypothyroidism found to have sensorineural hearing loss.

Research design:  Case report.

Study sample:  Single subject.

Intervention:  Diagnosis of congenital hypothyroidism at 1 week of life and initiation of treatment with levothyroxine.

Data collection and analysis:  Degree of hearing loss was measured with age-appropriate audiological testing at ages 4 weeks, 7 weeks, 3 months, 7 months, 9 months, 11 months, and 12 months.

Results:  The patient was treated early with thyroid hormone supplementation and demonstrated full recovery of hearing by age 12 months.

Conclusions:  Despite the body of literature documenting hearing loss as an ongoing complication of CH, this patient demonstrates a unique case of full hearing recovery with early treatment.

Background:  Cervical vestibular-evoked myogenic potentials (cVEMPs) and masseter vestibular-evoked myogenic potentials (mVEMPs) are considered to have a common saccular origin. While a few studies have examined both vestibular-evoked myogenic potentials (VEMPs) in individuals with brainstem disorders as part of a test battery, the relation between these two potentials has rarely been the subject of discussion.

Purpose:  The present study explored the relation between mVEMPs and cVEMPs using electromyography (EMG)-scaled parameters in normal-hearing young adults.

Research design:  Within-subject study design.

Study sample:  Twenty young adults between 18 and 39 years of age (11 males, 9 females) participated in the study.

Data collection and analysis:  cVEMP and mVEMP were performed on all the participants at 95 dBnHL with 500 Hz tone burst stimuli. Various VEMP parameters were evaluated including P13 and N23 peak latencies, the amplitude of the P13-N23 complex, and the Interaural Amplitude Asymmetry Ratio in EMG-scaled and unscaled conditions.

Results:  All participants exhibited a 100% response rate for cVEMP and mVEMP responses. There were no significant ears and gender effect for both cVEMP and mVEMP. No correlation was found between cVEMP and mVEMP. There was no significant difference found between P1 and N1 latency values of cVEMP and mVEMP; however, a significant variation was observed for peak-to-peak amplitude both in EMG-scaled and unscaled conditions between cVEMP and mVEMP.

Conclusions:  Minimal to no association between any parameters of cVEMPs and mVEMPs suggests no significant relationship between these two VEMPs.

Background:  Cases of self-reported hearing difficulty despite no traditionally measured hearing loss (pure tone audiometric thresholds ≤ 25 dB HL from 250 Hz through 8000 Hz) have risen with the return of Veterans from recent conflicts in Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn. Auditory outcomes improved despite low compliance among those receiving treatment. Medical chart data appeared more comprehensive for Veterans with, rather than without, auditory complaints. One possibility is that self-reported hearing problems are associated with a subset of these comorbidities, the treatment of which improved auditory outcomes.

Purpose:  This study examined the relationships between Veterans' self-reported auditory problems and other diagnosed medical conditions.

Research design:  A retrospective chart review was used.

Study sample:  Participants were 286 Veterans, aged 21 to 52 years with pure-tone audiometric thresholds ≤ 25 dB HL at all measured frequencies in both ears. Veterans were dichotomized into a group with either self-reported hearing complaints (n = 143) or an age-matched control group with no auditory complaints (n = 143).

Data collection and analysis:  A query of the Computerized Patient Record System was performed with the date range restricted to 2009 to 2018. Metrics of self-perceived hearing handicap, auditory processing disorder testing, and hearing aid use were collected. All diagnoses and related symptoms were recorded. A best subsets regression with principled model selection was performed to investigate the role of these comorbidities on self-perceived hearing loss.

Results:  The self-report group had 16 comorbidities that were classified as prevalent, having occurred in ≥33.3% of the group, compared with the age-matched control group, which had 2 comorbidities. The number of diagnosed medical conditions was associated with self-perceived hearing impairment. Specifically, posttraumatic stress disorder (PTSD) and related symptom clusters constituted the largest group of comorbidities that were significantly associated with self-reported hearing problems.

Conclusions:  The significant association between PTSD and self-perceived hearing impairment warrants investigations on whether treatment of PTSD would reduce perceived hearing handicap severity. Further, PTSD assessments could be useful for audiologists to identify potential candidates for auditory complaints without measured hearing loss.

Background:  Speech recognition in adult cochlear implant (CI) users is typically assessed using sentence materials with low talker variability. Little is known about the effects of talker variability on speech recognition in adult CI users, the factors underlying individual differences in speech recognition with high talker variability, or how sentence materials with high talker variability could be utilized clinically.

Purpose:  To examine the effects of talker variability on sentence recognition in adult CI users, using sentences from the Perceptually Robust English Sentence Test Open-Set (PRESTO), and to examine the relation between working memory capacity and high-variability speech recognition.

Research design:  Postlingually deafened adult CI users and adults with self-reported normal hearing (NH) under CI simulation completed sentence recognition tests that contained varying levels of talker variability, including Hearing in Noise Test (HINT; low-variability), AzBio (moderate-variability), and PRESTO sentences (high-variability). The tasks were completed in both quiet and multitalker babble (MTB). For the adult CI users only, the relation between sentence recognition accuracy and working memory capacity was assessed.

Study sample:  Twenty postlingually deafened adult CI users and 35 NH adults under 8-channel acoustic noise-vocoder simulations of CI hearing.

Results:  In both CI and NH groups, performance decreased as a function of increased talker variability, with the best scores obtained on HINT (low-variability), then AzBio (moderate-variability), followed by PRESTO (high-variability) in quiet. In MTB, performance was significantly lower on PRESTO sentences, compared with HINT and AzBio sentences, which were not significantly different. Working memory capacity in the CI users was related to sentence recognition accuracy across all materials and conditions.

Conclusion:  Findings from the current study suggest that the increased talker variability in the PRESTO sentence materials has a detrimental effect on speech recognition in both adult CI users and NH listeners under CI simulation, particularly when speech is further degraded by MTB. For adult CI users, working memory capacity contributes to speech recognition abilities. Sentence recognition testing with high-variability, multitalker materials, as in PRESTO, provides robust assessment of speech recognition abilities for research and clinical application, generating a wide range of scores for evaluating individual differences without ceiling effects when compared with conventional low-variability sentences.

Background:  Auditory problems are ubiquitous among U.S. military personnel. Hearing aids are an effective treatment for both hearing loss and tinnitus, two of the most common diagnoses among veterans awarded disability compensation, but the prevalence of hearing aid requirements in the U.S. military is unknown. Another military health problem is posttraumatic stress disorder (PTSD), an anxiety disorder characterized by exposure to a traumatic event. While some studies have found an association between auditory problems and PTSD, no research has examined the relationship between hearing aid requirements and PTSD.

Purpose:  To identify the prevalence of self-reported hearing aid requirements in U.S. military personnel and examine the association with PTSD.

Research design:  Cross-sectional study.

Study sample:  The study population included 104,728 U.S. Navy and Marine Corps service members who completed a Periodic Health Assessment between August and December 2021.

Data analysis:  Prevalence of self-reported hearing aid requirements was calculated. A multivariable logistic regression model was used to determine the association between hearing aid requirements and PTSD, while adjusting for covariates.

Results:  Overall, 1.0% (1,088/104,728) of the study population self-reported requiring hearing aids. Hearing aid requirements were positively associated with age, and the highest prevalence was among those aged 40 years and older (3.8%). There was also a statistically higher prevalence among men compared with women (1.2 vs. 0.5%), Marines compared with Navy personnel (1.2 vs. 0.9%), and active duty compared with National Guard/Reserve components (1.1 vs. 0.6%). A significantly higher proportion of service members who required hearing aids screened positive for PTSD than those without hearing aids (30.4 vs. 7.5%). In multivariable regression, those who required a hearing aid, compared with those who did not, had more than three times higher odds of screening positive for PTSD (odds ratio: 3.45; 95% confidence interval: 3.00-3.96).

Conclusion:  To our knowledge, this is the first study to report the prevalence of self-reported hearing aid requirements in the U.S. military as well as an association between requiring hearing aids and screening positive for PTSD. Our findings reaffirm the need for interprofessional collaboration between audiologists and psychological health professionals when providing care for these patients.

Background:  Falls are a major health concern with potentially dramatic consequences for people over 65 years of age. One crucial determinant in the risk of falls in older adults is postural control, a complex process that requires the contribution of different sensory modalities, namely visual, vestibular, auditory, and somatosensory. While there are well-established methods to screen for age-related vision, hearing, tactile, and vestibular impairments, there are very few widely available methods to screen for somatosensory function, but studies indicate that ankle audiometry (vibration thresholds) using a common B-71 bone vibrator can serve that purpose. To date, unfortunately, this technique has received little attention as a tool to measure postural instability in older adults.

Purpose:  The objective of the present study was to examine postural control in older adults with and without degradation of the somatosensory functions, as determined with ankle audiometry.

Research design:  This was standard group comparison.

Study sample:  In total, 36 healthy elderly aged between 65 and 80 years old were divided into two groups (low vibration threshold [n = 18] and high vibration threshold [n = 18]).

Data collection and analysis:  Standard audiometry, video head impulse test, vibration thresholds (big toe, ankle, and tibia), and static postural control task using a force platform were performed.

Results:  Greater postural instability in participants with higher (worse) vibration thresholds as compared with participants with lower (better) vibration thresholds was observed even though both groups were comparable on hearing threshold and vestibular function.

Conclusion:  The results indicate that performing a simple vibration threshold evaluation, using a clinically available B-71 with a cut-off value of 42 dB hearing loss, could be an effective, fast, and easy-to-use procedure for detecting people at risk of falls.

Background:  Spatial orientation is an executive function which includes vital activities and auditory organization according to daily bodily movements, directionality, and environmental information. It is directly linked to the vision and hearing and used throughout life, building complex relationships with these systems, based on learning.

Purpose:  Our purpose in our study is to try to see the effects of noise and reverberation on the users by comparing the localization and auditory performances of the cochlear implant (CI) user individuals in a silent, noisy environment and reverberation.

Research design:  All subjects were subjected to immitancemetric/audiological tests, language development test (TIFALDI, Receptive/Expressive Language Test score 7 years and above), localization determination in noise, and localization determination test in reverberation. Study sample: In our study, 18 female and 16 male bilateral CI users with profound sensorineural hearing loss were included. The age range of subjects was 8 years 4 months and 10 years 11 months.

Data collection and analysis:  Data from subjects were collected prospectively. Data analysis was analyzed with SPSS 21 program.

Results:  It was observed that the subjects did not have difficulty in determining the direction in silent condition, but they had a significant difficulty in localizing the 135-, 225-, and 315-degree angles especially when the noise was signal-to-noise ratio (SNR) -10 dB and the reverberation was 06 and 09 second (p ≤ 0.005). Subjects' performances were significantly altered in sequential implanted users both when the SNR was changed and in the presence of reverberation (p < 0.05).

Conclusion:  As a result of our study, it is thought that individuals with hearing loss will experience intense difficulties, especially in noisy and reverberant environments such as schools, and using assistive listening devices in these environmental conditions will contribute positively to their academic development.